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      Dengue and US Military Operations from the Spanish–American War through Today

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          Abstract

          Dengue may remain problematic for military personnel until an effective vaccine is licensed.

          Abstract

          Dengue is a major cause of illness among travelers and a threat to military troops operating in areas to which it is endemic. Before and during World War II, dengue frequently occurred in US military personnel in Asia and the South Pacific. From the 1960s into the 1990s, dengue often occurred in US troops in Vietnam, the Philippines, Somalia, and Haiti. We found attack rates as high as 80% and periods of convalescence up to 3-1/2 weeks beyond the acute illness. The increase in dengue throughout the world suggests that it will remain a problem for military personnel until an effective vaccine is licensed.

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          Most cited references20

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          Research on dengue during World War II.

          A SABIN (1952)
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            Natural history of dengue virus (DENV)-1 and DENV-4 infections: reanalysis of classic studies.

            The natural history of wild-type dengue virus (DENV) infections of humans, including incubation and infectious periods, requires further study. Two experimental studies in the Philippines of DENV-4 (1924-1925) and DENV-1 (1929-1930) were reexamined. The intrinsic incubation periods were fitted to log-normal distribution using the maximum likelihood method, and the infectious and extrinsic incubation periods were assessed by proportions of successful transmissions causing clinically apparent dengue. Correlations between the intrinsic incubation period and other variables and univariate associations between clinical severity and serotype were also examined. Mean+/-SD incubation periods were 6.0+/-1.4 and 5.7+/-1.5 days for DENV-4 and DENV-1, respectively. Significant negative correlations were observed between the incubation period and duration of fever (r=-0.43 and -0.33). Even 1 and 2 days before the onset of fever, 80.0% (95% confidence interval [CI], 44.9%-100%) and 25.0% (CI, 0%-67.4%) of biting experiments caused clinically apparent dengue. DENV-1 infections resulted in a significantly longer duration of fever than DENV-4 infections (P<.01). Incubation period was negatively correlated with disease severity, potentially reflecting a dose-response mechanism. The historical data provided useful details concerning serotype differences in the natural history of primary DENV infections.
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              Viruses associated with epidemic hemorrhagic fevers of the Philippines and Thailand.

              Epidemiologic, clinical, and etiologic studies were carried out on a newly recognized, frequently fatal, pediatric disease syndrome which occurred in urban areas infested with Aedes aegypti mosquitoes. Four types of dengue virus (two of which are new), chikungunya virus, and another virus yet to be identified were isolated from the blood of patients. Dengue viruses, types 2 and 3, were isolated from the mosquitoes. Ample serologic confirmation was obtained of concurrent hemorrhagic fever and infection with one or more of these viruses. Thus, it was discovered that viruses of previously recognized types and of closely related new types apparently have etiologic roles in a new and highly dangerous epidemic disease syndrome.
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                Author and article information

                Journal
                Emerg Infect Dis
                Emerging Infect. Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                April 2012
                : 18
                : 4
                : 623-630
                Affiliations
                [1]Armed Forces Research Institute of Medical Science, Bangkok, Thailand (R.V. Gibbons);
                [2]Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA (M. Streitz, T. Babina);
                [3]Mahidol-Oxford Tropical Medicine Research Unit, Bangkok (J.R. Fried)
                Author notes
                Address for correspondence: Robert V. Gibbons, Department of Virology, Armed Forces Research Institute of Medical Science (AFRIMS), USAMC-AFRIMS, APO AP 96546, USA; email: robert.gibbons@ 123456afrims.org
                Article
                11-0134
                10.3201/eid1804.110134
                3309667
                22469290
                9a027545-aa97-4f20-9fbd-0de37c7479f9
                History
                Categories
                Historical Review
                Historical Review

                Infectious disease & Microbiology
                dengue,vector-borne infections,military operations,viruses,united states,military personnel,history,spanish–american war,fever

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